San Pedro Town Council FoodBank Program

Application for San Pedro Town Council - LOW COST FOOD PROGRAM

This is a needs-based food assistance program.
This new program will allow qualified families to purchase a Food Bag for the sum of BZ$25.00 per bag. The program aim is for the Food Bag to have a retail value of BZ$40.00 and up. The money saved with this program can then be used on other expenses.

The Assistance Program is based on financial need. To qualify Applicants must provide evidence of financial need. The ultimate decision will be made by the Financial Aid Committee.

Note: Applicants who receive substantial financial aid from another source may have their application denied by the Financial Aid Committee after submission.

Application Process:

Individuals interested in applying for the Low Cost Food Program are to complete the application form below.
Name*

First NameLast Name
Birthdate

DayMonthYear
Date
Social Security Number*
Phone Number*
Email*
example@example.com
Home Address*

Street Address

Street Address Line 2

City

Postal / Zip Code
Marital Status*
Spouse/ Partner Name

First NameLast Name
Spouse Phone Number
Does any family member have any disabilities?*

NoYes
If Yes give details of disabilities
Is any family member pregnant?*

YesNo
How many dependents (persons under 21, over 65 or with a disability) live with you?*

How many of these dependents are attending school?

EXPENSES: VERIFICATION OF ALL INCOME/ EXPENSES IS REQUIRED

EMPLOYMENT/VERIFICATION OF ALL INCOME/ EXPENSES IS REQUIRED

If you are NOT working, why not? Please explain:
Do you receive MAINTENANCE income for any of your children?*

NoYesIf Yes, give amount
Are you receiving assistance from any other source? If yes, please explain:

SPOUSE/ PARTNER EMPLOYMENT/INCOME: VERIFICATION OF ALL INCOME/ EXPENSES IS REQUIRED

If he/she is NOT working, why not? Please explain:
Please explain how you have been impacted by COVID-19 and how this program would benefit you:*
Date*

MonthDayYear
Date
Signature*

Clear
More Information:

Contact Councillor Dianeli 'Danni' Aranda - 673-2199.

Women, Youths and Children Affairs Office inside Island Galleria Building, Corner Coconut Drive & Tarpon Street, San Pedro Town, Ambergris Caye, Belize.

Monday to Friday: 10am to 12pm and 1:30pm to 4pm.
Should be Empty:

Application for San Pedro Town Council - LOW COST FOOD PROGRAM